Inspection on 19/07/06 for 21 Dimmingsdale Bank

This inspection was carried out on 19th July 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

21 Dimmingsdale Bank 21/08/08

21 Dimmingsdale Bank 13/09/07

21 Dimmingsdale Bank 19/01/06

21 Dimmingsdale Bank 01/09/05

21 Dimmingsdale Bank 11/03/05

21 Dimmingsdale Bank 12/10/04

21 Dimmingsdale Bank 26/03/04

21 Dimmingsdale Bank 07/08/03

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

Ravenhurst

Polesworth Group 64 Long Street

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Dimmingsdale Bank, 21 Woodgate Valley Birmingham West Midlands B32 1ST Lead Inspector Sarah Bennett Unannounced Inspection 19th July 2006 12:10 Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Dimmingsdale Bank, 21 Address Woodgate Valley Birmingham West Midlands B32 1ST 0121 422 7500 F/P 0121 422 7500 yvetteperville@trident-ha.org.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Trident Housing Association Yvette Purville (not yet registered) Care Home 7 Category(ies) of Learning disability (7), Physical disability (7) registration, with number of places Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents must be aged under 65 years Date of last inspection 19th January 2006 Brief Description of the Service: Dimmingsdale Bank is a purpose built home for seven people who have a learning and additional physical disability. It was first registered in 1995. It is situated in a residential area on the south side of the city known as Woodgate Valley. It is within easy reach of local shops, public transport and local amenities. The property comprises of three linked houses, set out with a pleasing frontage of small areas of shrubs and spacious off road parking. The facilities include a large open plan communal area, which is utilised as a combined lounge and dining room. There is a main kitchen, and five bedrooms, all with en suite facilities, which can be accessed directly from the combined lounge/dining area. The office, sleep-in accommodation, laundry and a further two bedrooms are located on the first floor accessed via a stair lift. To the rear of the property there is a cushioned or astro turf patio with flowerpots, surrounded by a raised lawn and shrubbery. Due to the gradient of the lawn service users are not able to access it. Wheelchair access into the house and out to the rear garden is evident. The ground floor facilities are fully accessible. However, the first floor accommodation can only be utilised by those who are able to use a stair lift. The statement of purpose stated that the fees per week start from £810.00, which includes accommodation, care and support, laundry and all meals within the home. Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the fieldwork visit taking place a range of information was gathered to include notifications received from the home, a completed pre–inspection questionnaire and reports from the provider. The Manager was not on duty at the time of the visit so there was not access to staff records. A sample of these was forwarded to the CSCI as requested. One inspector carried out the unannounced fieldwork visit over six and a half hours. This was the homes key inspection for the inspection year 2006 to 2007. The Deputy Manager and the staff on duty were spoken to. Conversations with some service users were limited due to their complex needs and limited verbal communication. The inspector met with all the service users and time was spent observing care practices, interactions and support from staff. A tour of the premises took place. Care, staff and health and safety records were looked at. What the service does well: What has improved since the last inspection? Each service user had a care plan so that staff know how to support the person to meet their needs and achieve their goals and aspirations. Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 6 There are more activities for service users to do at home. They said what they would like to do such as play table football and bingo and staff made sure that these were bought. Staff spent time playing games with some of the service users. Each service user had a Health Action Plan so that staff know how to support them to stay healthy and access the right healthcare services. All staff have had training in preventing abuse so that they know how to protect service users from harm. There was new furniture in the lounge to make it more comfortable for the service users to sit in. Water temperatures were at safe levels so that the water was not too hot or cold for the service users. Staff regularly test the fire equipment to make sure it is working. What they could do better: Care plans must be reviewed every six months so that if individuals needs have changed staff know how to support them appropriately. All service users must be offered a range of activities to ensure that they experience a meaningful quality of life. All service users must be offered a healthy and nutritious diet. All health appointments that service users go to must be recorded with the outcome and any recommendations made. These will make sure that individual’s health needs are met. Behaviour management guidelines must be regularly reviewed to make sure that individual’s behaviour is being managed appropriately and all staff know how to do this. The staff vacancies must be filled so that all staff working at the home know the service users well and can support them to meet their individual needs. All staff must have updated training in moving and handling and fire safety to make sure they know how to protect the service users from harm. The quality assurance system must be completed to make sure that service users views help to develop a plan for the home on how to move forward, thereby improving the overall quality of life for service users who live there. Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 5 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users have the information they need to make an informed choice about whether or not they want to live at the home. Producing this in alternative formats will make this information easier to understand. Prospective service users individual aspirations and needs are assessed. Service users are aware of the terms and conditions of their stay at the home and their rights and responsibilities. EVIDENCE: The statement of purpose and service users guide included all the relevant and required information. The service users guide was not in a format accessible to the people who live in the home. Consideration should be given as to an alternative format that would make it easier for the service users to understand. The current service users have lived at the home for several years so it was not possible to assess the recent admission process and assessment. However, the admission criteria states that an assessment of prospective service users would take place several weeks in advance of someone moving in. This would include relevant history of the person, input from previous home/family, reports of medical/social history including medication required and support Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 10 strategies to assess whether the home can meet the individual’s needs and support them to achieve their goals. Service users records sampled included a licence agreement. This stated the terms and conditions of the individual’s stay at the home including their rights and responsibilities. These were signed and dated by the service user or their representative and the Manager. Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Staff have the information they need to support service users to meet their needs and achieve their goals but plans need to be more person centred so that all individuals wishes are considered. Service users are supported to make decisions about their day-to-day lives and are consulted on the running of the home. Service users are supported to take risks within a risk assessment framework . EVIDENCE: Two service users records were sampled. These included individual care plans that state how staff are to support the individual to meet their needs and achieve their goals. These include areas of supporting the person with their personal care, self-help skills, eating and drinking, mobility, behaviour, health needs, finances, emotional and psychological, contact with their family and friends, communication, religious beliefs and leisure opportunities. Care plans included the required information but were not person centred. Trident uses a format called ‘Essential Life Planning’ (ELP) that is person centred and includes more detail about the wishes of the individual in their care. These are produced Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 12 using pictures that would make the care plan easier for the person to understand. One of the service users ELP was not completed at all and the other was partially completed. Annual reviews are held of individuals care plan and where appropriate their relatives are invited to these. The care plan states that it will be reviewed with the individual and their key worker after six months but there was no evidence that this had been done. Care plans must be reviewed every six months and updated if there are any changes to the individual’s needs or goals. Records sampled and observations made showed that service users are supported to make decisions about their day-to-day lives. Service users were asked what they wanted to do, where they wanted to sit to eat their evening meal, -inside or in the garden and what they wanted to eat and drink. Regular service users meetings are held. The Trident Service User Participation Officer chairs these meetings. In June the minutes stated that service users requested that more in-house activities such as bingo, table football, cards and games be bought. These had since been bought and service users were observed playing these. Minutes stated that service users discussed where they would like to go on holiday and how they would like to travel there either by train or using the home’s vehicle, what they want to eat and the furniture and decoration of the home. Records sampled included individual risk assessments. These detailed how staff are to support the individual to minimise the risks involved when using public transport or travelling in the home’s vehicle, at night, when being moved in the hoist, epilepsy, if there was a fire, using bed rails, eating and drinking, bathing, individual’s behaviours and accessing the community. Risk assessments had been regularly reviewed and updated where there were changes to ensure that the current risks to the individual were fully assessed. Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 The quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. Arrangements are in place so that generally people living in the home experience a meaningful lifestyle. Service users enjoy their meals but it is not always clear that they are offered a healthy diet. EVIDENCE: Five of the service users regularly go to local day centres from Monday to Friday. Staff provide the day care for the other two service users. One of the service users records sampled showed that in July apart from going to the day centre they had only been out once to a disco. The Manager had put a message to staff in the communication book about lack of activities for this person stating that these needed to be more varied. Inside the home their records stated that they had watched TV and listened to music. The other service users records sampled showed that they go shopping, to restaurants, go to discos, watch TV, play games, read magazines and watch films. Staff at the home provide this person’s day care and funding for twenty hours per Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 14 week of 1:1 support is provided. Staff were playing table football and other games with some of the service users. All service users are going on holiday supported by staff to Blackpool. They are not staying in the same hotel but in two different ones. Some service users are travelling there by train and some are going in the home’s vehicle. Service users records sampled showed that staff support individuals to maintain contact with their family and friends through letters, phone calls and sending cards and presents for special occasions. Service users said that their relatives visit them and they sometimes go to visit their relatives. They said they meet their friends at the day centre and at the disco that they often go to. Care plans sampled stated how staff are to support service users to be as independent as possible. Daily records sampled showed that service users helped to prepare their breakfast and were involved in choosing their own clothes to buy and to wear. One of the service users was helping to prepare the evening meal and others were laying the table. Service users said that they had helped to plant the hanging baskets and pots in the garden and often helped to water these. One of the service users had been to the supermarket with staff to do the food shopping. Each service user has their own weekly menu that includes an alternative for each meal. Staff were observed offering service users a choice of which meal they wanted. The menu is displayed in pictures on a board in the dining room to help some service users to choose what they would like. Records of what the person ate are kept. The records for one of the service users sampled stated that in one week they had scampi and chips twice and had chips for their main meal on five of the seven days. On the other days they had a buffet tea but it was not stated what this included and on the other day they had chicken curry. Another week sampled showed more variety for this person. One service users record stated on one of the days they had not eaten anything except an egg sandwich for breakfast. It was not clear whether they refused their meals or it had not been recorded. Staff were observed asking service users what they wanted for their evening meal. Fresh fruit and vegetables were available. Food cupboards were full of a variety of food. Staff sat with service users to eat their evening meal and supported them appropriately. Some service users chose to eat in the garden as it was a hot evening and others chose to eat inside. A choice of sauces and drinks were offered. Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 The quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. Service users generally receive personal support in the way they prefer and require. Records of health appointments need to improve to evidence that service users health needs are being met. Arrangements are in place to ensure that the management of the medication protects service users. EVIDENCE: Service users were dressed in good quality clothes appropriate to their age, the weather and the activities they were doing. Each service user had their own individual style of dress and hair. Service users records sampled included very detailed guidelines for staff to follow on how to support individuals with their personal care and daily routines. Staff were observed supporting one person to go to their bedroom to change their clothes. Staff encouraged the individual to transfer from the chair to their wheelchair on their own. As it was a hot day staff ensured that all service users were offered several cold drinks to keep them cool and hydrated. Two service users bedrooms are on the first floor, which is accessed by a stair lift. Service users require support from staff when using the stair lift and ask Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 16 for this by pressing an intercom to alert staff. Staff were observed responding to this immediately and going to support the individual. One service user has a health condition which means that they often fall. The person stood up and fell over in the lounge. Staff immediately went to assist them and reassured them whilst checking for injuries. Fortunately they were not injured so two members of staff supported them to get off the floor to stand up. One member of staff moved up from the floor with the service user but the other member of staff bent over and helped the service user by pulling them off the floor. This move could risk injury to the member of staff and the service user. All staff must have regular training in moving and handling and must follow the training given. Health professionals are involved in the care of individual service users where appropriate. These include the Speech and Language Therapist, Occupational Therapist, Psychiatrist, Physiotherapist, Dietician, Continence Nurse and referrals to the Falls Clinic. The chiropodist visited several service users in the early evening and provided care in individual’s bedrooms. Records sampled showed that service users had regular check ups with the chiropodist and the optician. One record sampled stated that the person should have a dental check up every six months but there was no record that they had been to the dentist. Staff said that they thought this person went regularly to the dentists but it is likely that it had not been recorded. These records must be kept so that it is clear that the person’s health needs are being met and any recommendations from the dentist or other health professional can be met. Each service user had a Health Action Plan. This is a personal plan about what support a person needs to stay healthy and to access appropriate healthcare services. Boots supply the medication to the service users using the monitored dosage system. Medication is stored in a locked cabinet. Two members of staff give medication to the service users to reduce the risks of errors occurring. Medication Administration Records (MAR) had been signed appropriately. The MAR cross-referenced to the blister pack indicating that medication had been given as prescribed. Where service users are prescribed PRN (As required) medication a protocol is in place stating when, why and how this should be given. When PRN medication had been administered staff had signed on the back of the MAR to state when, why and in what dosage they had given it to the individual. One of the service users medication sampled was not kept in the blister pack. Staff had signed on the box when they had opened it and the right amount of tablets had been given according to the dosage prescribed. Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to ensure that service users views are listened to and acted on. Arrangements are generally sufficient to ensure that service users are protected from abuse, neglect and self-harm. EVIDENCE: Service users records sampled included a copy of the complaints procedure. The procedure stated how to make a complaint and who to make it to. This included the CSCI and how to contact them. Service user meting minutes showed that staff discussed with the service users how to make a complaint if they are unhappy with the service provided at the home. The pre-inspection questionnaire stated that in the last 12 months there had been no complaints made. The CSCI had not received any complaints about the home. The Area Manager said that since the last inspection all staff had received training in adult protection and how to prevent abuse from happening. Two service users financial records were sampled. Money in individual purses or wallets cross-referenced with the amount stated on the financial record. Receipts are kept of all purchases and these cross-referenced with the amount spent on the records. Service users have their own bank accounts. Statements of these showed that their benefits are regularly paid into these and they regularly receive their personal allowance. Records showed that this is spent on personal items and not used to purchase things for the home. Staff check service users money each day at the handover of shifts to make sure that no money has gone missing. The Manager completes a weekly audit of the money Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 18 to ensure that calculations are correct and that individual’s money is being used appropriately. Service users records sampled included individual behaviour management guidelines that stated how staff are to manage behaviour that can be ‘challenging’ to minimise the risks involved. These included distraction techniques and not physical intervention by staff. One guideline was dated 2002 and there was no evidence that it had been reviewed since. Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 28, 29, 30 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a homely, comfortable and safe environment that generally meets their individual needs. EVIDENCE: Since the last inspection new sofas and cushions had been provided in the lounge. Minutes of service users meetings stated and service users said that they had been involved in choosing these. At the last inspection it was noted that there were several stains on the lounge carpet however it was evident that this had been cleaned and was generally free of stains. There were pictures on the walls making it look homely. A requirement was made at the last inspection for the lounge and dining room to be redecorated. Staff said that this had not been done as the decoration is done on a cyclical basis and is not yet due. However, where necessary paintwork had been patched up to ensure that the rooms looked clean and comfortable. In the garden there were several attractive pots and hanging baskets on the patio. This is the only part of the garden that is accessible to all service users as the grassed areas are raised up to the fence that surrounds the garden. Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 20 However, staff had ensured that this is a place that service users can enjoy using and garden furniture and parasols were provided. Service users records sampled showed that where appropriate they are referred to an Occupational Therapist to ensure that they have the aids and adaptations they need to be as independent as possible. Records showed that service users wheelchairs and hoists are regularly serviced to make sure they are safe to use. The home was clean and free from offensive odours. Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36 The quality outcome in this area is good. This judgement has been made using available evidence including a visit to this service. The arrangements for staffing and their support and development are generally sufficient to ensure that an effective staff team supports service users and meets their individual needs. Service users are protected by the home’s recruitment policy and practices. EVIDENCE: The statement of purpose stated six members of staff have achieved NVQ level 2 in Care and one member of staff has level 3 in Promoting Independence. This exceeds this standard that over 50 of the staff team have NVQ level 2 or above in Care. It also stated, “ Trident Housing Association are committed to training all social care workers to NVQ level 2 in Care.” The Deputy Manager had been seconded from another home managed by Trident for a period of two months. The Area Manager said that there are four full-time staff vacancies. They are trying to get agency staff that have temporary contracts to be employed as permanent staff to offer some consistency to the service users. Staff from the agency that had recently been employed on permanent contracts currently fill the two waking night posts. Agency staff that work regularly at the home were on the late shift. It was evident that they knew the service users and service users knew their names and were comfortable talking to them and playing games. Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 22 Minutes of staff meetings showed that these are held regularly. These are focussed on the needs and goals of the people that live in the home to make sure that all staff know how to support individuals appropriately. Staff records sampled included the required recruitment records. These included evidence that a Criminal Records Bureau (CRB) check had been undertaken to ensure that suitable people are employed to work with the service users. Training records sampled showed that staff had received training in food hygiene, adult protection and the prevention of abuse, first aid, health and safety, epilepsy and communication. Staff had not received fire safety training every six months to ensure they are reminded of how to prevent fires starting and what to do if there is a fire. Some staff had not received updated training in moving and handling. Staff records sampled evidenced that staff had received regular, formal, recorded supervision sessions with their line manager. In these sessions they had discussed the needs of the service users and how they were supporting them and identified any training and development needs that would help them in their role. Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 The quality outcome in this area is adequate. This judgement has been made using available evidence including a visit to this service. The Manager has improved the management arrangements to ensure that service users benefit from a well run home. Registration with the CSCI will ensure that this arrangement is consistent and further improves this. The quality assurance system does not record that it has been used recently so it is not clear that service users views underpin all self-monitoring, review and development by the home. Service users health, safety and welfare are generally promoted and protected. EVIDENCE: The Manager is not yet registered with the CSCI. They have completed their registration application form but are waiting for their Criminal Record Bureau (CRB) check to be returned before the CSCI can process it. The Manager has worked with people who have learning and physical disabilities for several years and recently this was in a management role. She has NVQ level 4 in Care and is about to start her Registered Managers Award. Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 24 Trident has a comprehensive quality assurance system that looks at the quality of the care provided, the environment, the staff and the management and organisation. Most of this was completed by the previous manager but not dated so it was not clear when this was done. The Area Manager said that the Manager had looked at it and there were no changes to be made but this was not recorded. The Area Manager said that at the managers meeting the following week they would be looking at how the system is to be used and what strategies they are to use to ensure that it is used effectively. Trident has a Quality Assurance Team that includes relatives and representatives of service users. Some service user questionnaires were completed but they were not dated so it was not clear when these were completed. Fire records showed that an engineer regularly services the fire equipment. Regular fire drills are held so that service users and staff know what to do if there is a fire. Staff test the fire equipment regularly to make sure it is working properly. The fire risk assessment is regularly reviewed and stated how the risks of there being a fire are minimised as much as possible. The five - year electrical wiring test was last completed on 20/7/01 so was now in need of being done again. The Area Manager said that this is usually done automatically by the Maintenance Department however they will chase it up to ensure it is completed soon. An electrician tested the portable electrical appliances in April 2006 to make sure they are safe to use. A Corgi registered engineer tested the gas equipment in May 2006 and stated that it was in a satisfactory condition. An engineer regularly services the hoists and the stair lift to make sure they are safe to use. Staff test the fridge and freezer temperatures daily and records showed that these were within the limits for safe food storage. Staff test the water temperatures weekly to make sure they are not too hot or cold for the service users. Records of the last tests showed that these were between 40 – 41 degrees centigrade. The recommended safe temperature is 43 degrees centigrade. Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 x 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 2 29 3 30 3 STAFFING Standard No Score 31 x 32 4 33 2 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 2 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 3 x 2 x 2 x x 2 x Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 26 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15 (2) (b, c) Requirement Timescale for action 31/08/06 2. 3. 4. YA14 YA17 YA18 YA35 5. YA19 6. YA23 7. YA33 Service users care plans must be reviewed every six months and updated if there are nay changes. 16 (2) (m, A range of activities must be n) provided for all service users. 16 (2) (i) A healthy and nutritious diet must be provided for all service users. 13 (5) 18 All staff must receive regular (1) c updated training in moving and handling and must follow the guidelines in place. 12 (1) (a) A record must be kept of all Sch 3 (3) health appointments that service (m) users attend. These must include the outcome and if any recommendations have been made. 13 (4) (7) Behaviour management guidelines must be regularly reviewed and updated if there are any changes. 18 (1) (a) Outstanding from last inspection. Staffing vacancies must be recruited to. 20/08/06 13/08/06 31/08/06 31/08/06 31/08/06 31/10/06 Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 27 8. YA39 24(1)(a, b) (2)(3) 9. 10. YA42 YA35 YA42 23 (4) (a, d) 13 (4) (ac) Outstanding from last inspection The quality assurance system must be completed and dated. This should include seeking the views of service users and their representatives. All staff must receive fire safety training every six months. An electrician must complete the five- year electrical wiring test. A copy of this must be forwarded to the CSCI. 31/10/06 31/08/06 31/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA1 YA6 YA28 Good Practice Recommendations The service users guide should be produced in an accessible format for the people who live in the home and who may live there in the future. Service users should be supported to complete the ‘Essential Life Plans’ with their key worker and others involved in their care. The organisation should review the communal space for service users and the lack of a private area for service users to meet relatives/ friends other than their bedrooms. Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Dimmingsdale Bank, 21 DS0000016927.V298892.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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